FLAG FLOWN OVER THE CAPITOL IN HONOR OF YOUR EAGLE SCOUT
Information for mailing:
***** NOTE: REQUIRES MINIMUM 8-10 WEEK NOTICE *****

NAME:_____________________________________________________________

ADDRESS:__________________________________________________________

CITY:_________________________   STATE:______    ZIP:_________

PHONE NUMBER: ____________________________________

If flag is to be flown over the Capitol, fill in the following information
for use on the flag certificate:

Date you would like your flag flown over the Capitol:
_______________________________________
(If date is specified, order should be received 8-10 weeks prior to the date on which flag is to be flown.)

Person or organization for whom the flag will be flown:
____________________________________________

Occasion (if any):________________________________

The prices of the flags are as follows:

Size Quantity Type Total
3' x 5' x $9.00 Nylon Flag $
3' x 5' x $9.25 Cotton Flag .
5' x 8' x $18.00 Nylon Flag .
5' x 8' x $20.00 Cotton Flag .
Flying & Certification Cost x $4.05/flag . .
Shipping & Handling x $4.00/flag . .
Order Total $

Please make your check or money order payable to "Keeper of the Stationery" and return with completed form to the following address:

Senator Dianne Feinstein
ATTN: Flag Request
331 Hart Senate Office Building
Washington, DC 20510-0504

Due to the high volume of requests, please allow 8-10 weeks for processing and delivery.